• Jade Kettlewell, Kate Radford, Stephen Timmons, Trevor Jones, Stephen Fallon, Ryan Westley, Susan White, and Denise Kendrick.
• Centre for Academic Primary Care, School of Medicine, University of Nottingham, UK. Electronic address: Jade.kettlewell@nottingham.ac.uk.
• Injury. 2024 Sep 1; 55 (9): 111722111722.

ObjectiveMajor trauma 'Rehabilitation Prescriptions' aim to facilitate continuity of care and describe patient needs following discharge from UK Major Trauma Centre (MTCs), however research suggests rehabilitation prescriptions are not being implemented as intended. We aimed to identify factors influencing completion and use of rehabilitation prescriptions using the Behaviour Change Wheel (BCW) and Theoretical Domains Framework (TDF).DesignOnline survey informed by the TDF and BCW.SettingUK trauma rehabilitation pathway.PopulationRehabilitation and trauma service providers involved in completing and/or using rehabilitation prescriptions (n = 78).AnalysisMean scores were calculated for TDF behavioural domains, identifying facilitators (score ≥5) and barriers (≤3.5) to rehabilitation prescription implementation. Thematic analysis of free text data informed by the BCW/TDF identified further facilitators and barriers, plus potential behaviour change strategies.ResultsMost respondents worked in UK MTCs (n = 63) and were physiotherapists (n = 34), trauma rehabilitation coordinators (n = 16) or occupational therapists (n = 15). 'Social/professional role and identity', 'knowledge' and 'emotion' (the highest-scoring TDF domains) were facilitators to implementing rehabilitation prescriptions. Qualitative data identified barriers to rehabilitation prescription completion, including 'seen as tick-box exercise','not a priority', lack of resources (IT and workforce), poor inter-service communication, limited knowledge/training. Facilitators included therapist buy-in, standardised training, easy inter-service rehabilitation prescription transfer, usefulness for sharing patient needs.ConclusionsAlthough rehabilitation prescriptions are valued by some service providers, their effectiveness is hindered by negative attitudes, limited knowledge and poor communication. Uncertainties exist about whether rehabilitation prescriptions achieve their goals, particularly in documenting patient needs, engaging patients in rehabilitation, and informing onward referrals following MTC discharge. Improving IT systems, empowering patients, redirecting funding, and providing training might improve their usage. Further research should explore service provider and patient perspectives, and prospective long-term follow-up on outcomes of rehabilitation prescription recommendations.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

17 keywords...

hide…